Cardiovascular diseases (CVD) are adverse outcomes in patients with morbid obesity. Visceral adipocytes secrete the bioactive substances - adipokines that could mediate CVD progression in obesity. At the same time the paradoxical effects of different adipokines could lead to better survival in obese patients with heart failure. Recent studies were focused on drugs that could influence cardioprotective adipokines, and the results of clinical research are controversial. The role of adipokines in CVD development and prevention seems to be a possible novel target for research and therapy.